Home > Coalition: Civilian Health in Gaza in Grave Jeopardy from Attacks on Facilities, Ambulances, and Infrastructure

July 31, 2014

(Management Sciences for Health is a member of the Safeguarding Health in Conflict Coalition)

We, the undersigned members of the Safeguarding Health in Conflict Coalition[1], demand that the government of Israel, Hamas, and armed groups respect their obligations under international human rights and humanitarian law to respect and protect health facilities, transports, and personnel, and to make health services available to all people in need of care. The Safeguarding Health in Conflict Coalition promotes the security of health workers and services threatened by war or civil unrest.

According to the World Health Organization (WHO) situation report of July 29, 20% of the hospitals in Gaza have been damaged from shelling or other attacks. Five hospitals have closed, two are partially closed, and three others cannot operate because of lack of security for staff and patients.

The al Wafa medical rehabilitation hospital, damaged on several occasions in the past two weeks and evacuated on July 17, was reportedly completely destroyed by Israeli fire on July 23. The 100 bed Al-Aqsa hospital in central Gaza came under fire four times; on the last occasion an Israeli tank shell hit the third floor, killing four people, wounding 16, and forcing closure. WHO reports that patients and staff have died during attacks.

On July 25 Palestinian Ministry of Health emergency operations, which works in coordination with WHO and other international organizations, reported 12 ambulances have been damaged and 38 health personnel have been injured. Two pharmacists, two paramedics, and one administrative manager died after Israeli airstrikes hit in their immediate vicinity. WHO's July 29 report notes that two ambulance workers were killed on July 25 and three others injured when trying to evacuate wounded people from eastern and northern Gaza.

The deprivation of the right to access health care for people in Gaza extends beyond damage to facilities and transport. According to WHO, half of the 54 primary health clinics operated by the Ministry of Health have closed on account of insecurity, medical staff are unable to reach posts that remain open, ambulance workers have come under fire, and basic medical supplies have run dangerously low. WHO notes that "The coping capacity of health professionals is completely overstretched, and they are working under extreme and insecure conditions."

Public health, including access to potable water and sanitation, is also under threat. Humanitarian access for supplies, medicines, transports, clean water, and food during the crisis for more than half the people of Gaza has been obstructed.

All parties to the conflict must immediately respect obligations under international humanitarian and human rights law to assure preservation of health services and the right to health in Gaza.

Under international law, all sides have a responsibility to assure that access to health care be preserved, and attacks on health facilities or personnel, obstruction of access to facilities or passage of supplies, are strictly prohibited.

The parties have alleged violations by the other side, e.g., that Hamas has misused hospitals and ambulances for storage and firing of weapons and that Israel has targeted medical facilities and transports. "These claims await a full investigation. What is not in any doubt, however, is the unequivocal obligation under international law to protect civilians; even where one party breaches its obligations, the other must minimize harm to civilians," said Leonard Rubenstein, chair of the Coalition. All those who violate these fundamental standards must be held accountable.

We demand that health facilities, medical personnel, ambulances, and infrastructure be safe and secure for exercising their essential functions, permitting access to health care and public health infrastructure, safe evacuation of the wounded and sick, protection of civilians, and enabling health workers to perform their vital work.